[For the resubmission, research projects that received high (non-competitive) scores on the summary statement were eliminated as suggested by the PSC (Table 47).] Four research projects, which include career development plans (following References in each individual proposal [and in Appendix D]), are included in this application. Three projects are continuations from the previous U54 award. [These projects have been presented to the PSC Committee on an annual basis for feedback. All comments for revision have been incorporated into the projects.] In addition to the projects included on this application, funding is available for 2 pre-pilots during the 1st year and 1 pre-pilot during the 2nd year. During the 3rd year, funding is available for 1 pilot project. During the 4th year, funding is available for 3 full projects, 7 pilot projects or a combination of full, pilot and pre-pilot projects for up to 2 years. All projects will undergo a thorough IAC review process to be evaluated on their potential to expand into a larger project under the U54 mechanism and to compete for external funding (See Section 7). A description of each full and pilot project is included following this introduction. In addition to the research projects, this application includes a Cancer Training Program, a Cancer Outreach Program, and support cores as described in the RFA. The Outreach Program is the continuation of a 2-year Pilot Program that started late in the previous funding cycle.] 8.4 Solicitation of New Projects and Programs One of the main objectives of this Partnership is to facilitate the growth of independently-funded research at the MSI. To achieve this goal, aggressive advertising'and marketing strategies are needed to solicit the best proposals with an emphasis on building the foundation and infrastructure of the UPRCCC. A number of mechanisms will be used to solicit faculty from both institutions to begin collaborating including: 1) Partnership and UPR Websites;2) Campus Presentations;3) MSI Office of Sponsored Research;4)"email;5) Email Newsletters;and 6) Virtual Community. Title: Pilot Project A: Pilot Case-Comparison Study of Insulin Resistance, Adiponectin and Endometrial Cancer in Puerto Rico ABSTRACT Cancer of the uterine corpus is the most common gynecologic malignancy in the United States, with 40,100 new cases and 7,470 cancer-related deaths estimated for 2008. Similarly, in Puerto Rico endometrial cancer is the most common gynecologic malignancy, and the third leading cause of cancer in women behind breast and colorectal cancer. In the year 2003, there were 321 new cases of endometrial cancer reported to the Puerto Rico Cancer Registry, accounting for 6% of all cancers in women. Recent observations suggest that new pathways need to be considered, including evidence for a possible role of insulin and the insulin-like growth factor system. We will conduct a case-comparison hospital-based pilot study to assess the role of insulin resistance and adiponectin, a biomarker of insulin resistance, as risk factors for endometrial cancer among Puerto Rican women. One hundred women (21 years and older) with a newly diagnosed, histologically confirmed primary endometrial cancer will be selected at the Gynecologic Oncology clinic of the Department of Obstetrics and Gynecology at the University of Puerto Rico Medical Science Campus (UPR-MSC) and compared to 100 women selected among attendees to two Obstetrics and Gynecology clinics at the UPRMSC. Participants will undergo a face-to-face interview in which the following is collected: demographic information, smoking and drinking habits, weight history, personal and family medical history, reproductive and menstrual history, history of contraception and hormone replacement therapy, history of infertility, and levels of physical activity. In addition, women will undergo anthropometric measurements and collection of blood samples for measurements of insulin resistance. Insulin resistance (IR) will be measured using the quantitative insulin sensitivity check index (QUICKI). In addition, serum adiponectin levels, which correlate with insulin resistance, will be measured using a commercially available quantitative sandwich enzyme-linked immunoassay (ELISA). Univariate and multivariate unconditional logistic regression models will be used to assess the association of endometrial cancer with insulin resistance and serum adiponectin. The odds ratio (OR) and its 95% confidence intervals will be used to estimate the strength of the association between IR and other factors of interest and endometrial cancer. TITLE: Training the Next Generation of Hispanic Cancer Researchers ABSTRACT Early recruitment of underrepresented minorities to biomedical and health research training is essential to ensure that society's diversity is reflected in those professions. The objective of this proposal is to strengthen its partners'capabilities to contribute to significant increases in the participation of underrepresented minorities in nationally competitive cancer clinical and basic research. The University of Puerto Rico (UPR) and the University of Texas M. D. Anderson Cancer Center (MDACC) will continue to develop a comprehensive pipeline program from undergraduates to postgraduates that will increase the number of Hispanic students knowledgeable and committed to careers in cancer research and cancer medicine. The overall goal of this project is to encourage Hispanic science and medical students to pursue careers in cancer research and medicine and populate the faculty ranks at the UPR so as to strengthen cancer research at the University of Puerto Rico. The University of Puerto Rico (UPR) is conducting the training program with MDACC in several areas - biomedical and clinical research, didactics, enrichment experiences, M.D./PhD. training, postgraduate clinical training, training in cancer prevention and health disparities, and career development. The desired outcome will be achieved through a coordinated series of didactic and research experiences and enrichment activities that include on-campus cancer research at University of Puerto Rico Comprehensive Cancer Center (UPRCCC) during the academic year and summer research and year-round rotations to MDACC. The program draws upon the strengths of both institutions and brings benefits to both. TITLE: Puerto Rico Community Cancer Control Outreach Program ABSTRACT Cancer is the second leading cause of death among Hispanics in the US.(1) Despite the overall decline in cancer mortality over the last decade, Hispanics continue to experience disparities for certain cancers.<2) Breast and cervical cancer and tobacco-related cancers are among these.'113|4) Although smoking prevalence is lower in Puerto Rico (PR) compared to the US, tobacco exerts a tremendous public health burden, with 11.5% of all deaths and 10% of all health care costs in PR are attributable to smoking.(4>Among Puerto Rican women living in PR, breast cancer is the most commonly diagnosed neoplasm (35% of all cancers) and the leading cause of cancer deaths (15% of total).(9) Cervical cancer is the 4th most commonly diagnosed neoplasm in PR women, accounting for 4% of all newly diagnosed cancers, and 2.4% of all cancer-related deaths.(9) The purpose of the Puerto Rico Community Cancer Control Outreach Program (CCCOP) is to modify and sustain health behavior through the development of comprehensive, sustainable partnerships for cancer control outreach, education, research, and training in Puerto Rico (PR). Specifically, the purpose of the CCCOP is to decrease tobacco use, increase vaccination against Human Papilloma Virus (HPV), and increase breast and cervical cancer screening. Program components of the CCCOP will build upon collaborations, infrastructure, network development, and outreach successes achieved in the Outreach Pilot Project. The specific aims of the CCCOP are to: 1. Maintain, strengthen, and further develop a cancer control outreach network that will build upon existing relationships and develop new collaborations among the University of Puerto Rico Comprehensive Cancer Center (UPRCCC), The University of Texas M. D. Anderson Cancer Center (MDACC), and key Puerto Rican community and health organizations;2. Conduct a community assessment of needs and resources for breast and cervical cancer (BCCS) prevention and screening, tobacco control, and the elimination of disparities related to these cancers and behaviors;3. Develop health care provider and community organization capacity to implement and sustain culturally competent cancer control outreach and education programs to address disparities in breast and cervical cancers and tobacco control;4. Provide active mentoring and career development opportunities to U54 researchers and community partners to build capacity in cancer control and community-based participatory research;and, 5. Evaluate the impact of the CCCOP on increasing breast and cervical cancer screening, increasing HPV vaccination, and reducing tobacco use in PR. The proposed project provides benefits to both UPRCCC and MDACC as each partner brings unique expertise to the partnership. The CCCOP also includes major career development components to prepare cancer disparities researcher at both UPRCCC and MDACC. TITLE: Biostatistics and Bioinformatics Core ABSTRACT Rigorous application .of statistical methods and theory ensures that research will be conducted efficiently and increases the likelihood that useful data will be collected and correctly interpreted. The purpose of the Biostatistics and Bioinformatics Core (BBC) is to provide professional expertise in Biostatistics and Bioinformatics for all research studies within the Partnership. The investigators will have a close communication with the BBC at different stages of the projects, such as: study design, sampling design, sample size, random assignment, determination of statistical power, data description, data modeling, data management, quality control, database creation, keeping track of the database, merging files, updating files, data editing and filing, and retrieval of missing data. In addition, to improve our communication with the investigators, the BBC is planning to organize different workshops related with the statistical needs for every research studies, particularly with regression modeling (linear, logistic, multilevel), survival analysis, clinical trials, sample size, and power determination. Also, the BBC personnel will be involved in the assessment of new statistical methodologies in cancer research, particularly in microarray data analysis (McLachlan, et al, 2003) and genetic epidemiology (Suarez et al, 2007).